CHAPTER ONE

1.1 OBJECTIVES OF STUDENTS INDUSTRIAL WORKS

EXPERIENCE SCHEME (SIWES)
Specifically, the objectives of this scheme are to;
i. Provide an avenue for students in Nigerian Universities to acquire
industrial skills and experience in their course of study.
ii. Prepare students for the work situation they are likely to meet after
graduation.
iii. Expose students to work methods and techniques in handling
equipment and machinery that may not be available in the
Universities.
iv. Make the transition from the University to the world work easier and
thus enhance students’ contacts for latter job placement.
v. Provide students with an opportunity to apply their theoretical
Knowledge in real work situation, thereby bridging the gap between
university work and actual practice; and
vi. Enlist and strengthen employers’ involvement in the entire educational
process of preparing university graduates for employment in industry.

1.2 THE ROLE OF THE INDUSTRIAL TRAINING FUND

i. Provide logistics material needed to administer the scheme;
ii. Compile lists of employers and available training places for industrial
attachment and forward such lists to the Co-ordinating Agencies i.e
NUC, NBTE, NCCE;
iii. Organize biennial conferences and seminars on SIWES.

1.3 HISTORY OF FEDERALMEDICAL CENTER (FMC) UMUAHIA

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The Federal Medical Centre, Umuahia came into existence in November 1991.
It metamorphosed from the queen Elizabeth Hospital which was commissioned
on March 24, 1956 by Sir Clement Pleas representing Queen Elizabeth the
second of England. It started as a joint mission hospital administered by the
Methodist, Anglican and Presbyterian churches. Before its takeover by the
Federal Government, it had first been taken over from the missions by the then
Imo State Government under the then Military Governor – Navy Captain
Godwin Ndubuisi Kanu (now A retired rear Admiral). It was renamed Ramat
Specialist Hospital in honour of the late slain Head of State, General Murtala
Ramat Mohammed. During the first republic under the administration of late
Chief Sam Mbakwe, Governor of the old Imo state, it reverted to its original
name – Queen Elizabeth Hospital. It thus became the Federal Medical Centre
(FMC), Umuahia on its takeover in November 1991. It is the first FMC to be so
recognized.

1.3.1 Geography

The hospital covers an area 77 acres of land bounded on the south by the
Nigerian prisons, Umuahia; east by Ndume Ibeku; North by Umuahia urban and
west by Afara clan.

1.4 MISSION AND VISION STATEMENT

1.4.1 Mission of F.M.C. Umuahia

“As the foremost Federal Medical Centre, we provide specialized and

comprehensive health care services to our clients, using modern equipment,
training and research by highly skilled manpower, in a friendly environment”

1.4.2 Vision of F.M.C. Umuahia

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By 2019, we will improve the quality of existing services; increase our level of
research and the scope and depth of training and teaching. We will develop new
functional areas Renal Centre, Endoscopy Centre, Centre for in Vitro
Fertilization, Mammography Centre, Dermatology Unit, Oncology Unit,
Endocrinology Unit, and Respiratory Medicine Unit. We will achieve
accreditation in internal Medicine, Pediatrics, Family Medicine, Public Health,
Ophthalmology, and Anaesthiology. Human Resources Development to support
our growth and needs will be accorded priority. We will develop facilities to
support the above units and as well as attract medical tourism. We will be alive
to our social responsibility as a tertiary hospital.
We want to be seen as the foremost Federal Medical Centre providing
specialized and comprehensive health care using modern equipment, research
and training through highly motivated workforce operating in a friendly and
conducive environment that captures our antecedent as a mission hospital.

1.4.3 Motto of the Hospital

Serving Beyond your Expectation

1.4.4 Departments

 Chempath
 Clinical
 Community Development
 Haematology
 Medical Microbiology
 Medical Records
 Nursing Services
 Obstetrics and Gynaecology
 Opthalmology

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  Psychiatry
 Therapy 

1.5 ORGANOGRAM OF FMC UMUAHIA

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 CHAPTER TWO

DEPARTMENTS IN FEDERAL MEDICAL CENTER (FMC) UMUAHIA

2.1 VARIOUS DEPARTMENTS AND THEIR FUNCTIONS

2.1.1 Chemical Pathology Department

Chemical pathology (also known as clinical biochemistry) involves the

biochemical investigation of bodily fluids such as blood, urine and
cerebrospinal fluid. By discovering how and where the body’s chemistry has
changed, diseases can be diagnosed and monitored.

Many illnesses are reflected in a disturbance in the body’s chemistry. Chemical

pathology brings together science and medicine. By understanding the
chemistry of bodily fluids and monitoring these, laboratory professionals can
tell whether a patient’s organs are working properly, diagnose diseases and
recommend treatment.

2.1.2 Clinical Department

Clinical Unit means an area of nursing practice, as agreed between the parties,
and without limiting the foregoing shall include a ward, area or place of nursing
practice with a patient/client population.

Clinical duty means the permission to provide one or more direct patient care
services in the Hospital at the request or direction, and under the supervision of
a Staff Member.

2.1.3 Community Development Department

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Beyond its primary function to deliver health care services, hospitals and clinic
practices are often major employers in their communities. They also regularly
confront the physical and psychological consequences of social inequalities
experienced by patients. This month’s issue explores the roles health care
delivery organizations can play in supporting the economic and social fabric of
communities they serve.

2.1.4 Haematological Department

Haematology is the specialty responsible for the diagnosis and management of a

wide range of benign and malignant disorders of the red and white blood cells,
platelets and the coagulation system in adults and children. Haematologists care
directly for patients on hospital wards and outpatient clinics.
In the medical field, hematology includes the treatment of blood disorders and
malignancies, including types of hemophilia, blood clots, leukemia, lymphoma,
myeloma and sickle-cell anemia. Hematology is a branch of internal medicine
that deals with the physiology, pathology, etiology, diagnosis, treatment,
prognosis and prevention of blood-related disorders.

2.1.5 Medical microbiology Department

Medical microbiology is a clinical laboratory department providing diagnostic,

therapeutic, clinical, consultation, training and other supportive services in
infectious diseases and related conditions.

The department has well trained personnel who utilise up to date processes and
procedures to carry out testing on human and environmental specimens using
modern equipment in line with best international practices. In addition, our
clinical and support staff provide both clinical and consultation services as well
as public health support in a timely and efficient manner.

2.1.6 Medical Records Department

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Medical Records is a department organized to manage health information data
by ensuring its quality, accuracy, accessibility and security in both paper and
electronic systems. We properly classify and categorize patient information for
reimbursement purposes.
Medical Records Department is an integral part of patient care, which houses
the medical records of all the patients who have utilized the services of the
hospital.

2.1.7 Nursing Department

The nursing department is the organizational structure through which nurses

provide nursing care for clients under the jurisdiction of the institution. The
nursing department consists of nursing service and nursing education. The
primary purpose of the nursing service is to provide comprehensive, safe,
effective and well-organized nursing care through the personnel of the
department. The personnel consist of nursing superintendent, assistant nursing
superintendents, head nurses and staff nurses. All of these are registered nurses,
other personnel who function in the nursing service department may include the
auxiliary personnel nurse aids and domestics who handle the non-nursing
services.

2.1.8 Obstetrics and Gynaecology

They diagnose and treat conditions related to the reproductive system, such as
performing screening exams, offering birth control counseling, and preventing
infections. Most OB/GYNs perform surgery, and often consult with other
healthcare professionals. OB/GYNS work in outpatient clinics and hospitals.
Subspecialities and multidisciplinary team work – The Department has a full
complement of skilled and experienced subspecialists in Reproductive Medicine
and Endocrinology (REM), Maternal-Fetal Medicine (MFM), Gynaecology
Oncology (GO) and Uro-Gynaecology (UG) units.

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2.1.9 Opthalmology Department
a branch of medical science dealing with the structure, functions, and diseases
of the eye.
They diagnose, treat and prevent disorders of the eyes and visual system, using
medical and surgical skills.

2.1.10 Psychiatry Department

The department was created to offer specialist medical care in various fields of
Psychiatry to patients of all ages. The department also offers undergraduate and
postgraduate training in Psychiatry. With the goal is to providing quality,
prompt, courteous, empathic, confidential, comprehensive and effective services
in a clean, conducive and patient-friendly environment.

2.1.11 Therapy Department

Physical therapy (PT), also known as physiotherapy, is one of the allied health
professions.[1][2][3][4] It is provided by physical therapists who promote, maintain,
or restore health through physical examination, diagnosis, management,
prognosis, patient education, physical intervention, rehabilitation, disease
prevention, and health promotion. Physical therapists are known
as physiotherapists in many countries.
In addition to clinical practice, other aspects of physical therapist practice
include research, education, consultation, and health administration. Physical
therapy is provided as a primary care treatment or alongside, or in conjunction
with, other medical services. In some jurisdictions, such as the United
Kingdom, physical therapists have the authority to prescribe medication.

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 CHAPTER THREE

EQUIPMENT AND INSTRUMENTS USED AND THEIR USES

3.1 Kitchen Weighing Scales: The kitchen unit has two types of weighing
scales that are used in the kitchen to measure food items.
I. Electronic weighing scale.
II. Manual weighing scale.
In the kitchen food items can be weighed with either of these weighing scales.
The electronic weighing scale is mainly used to weigh items that have less
weight which may not be very sensitive on the manual scale, especially in food
standardization. On the other hand, the manual weighing scale is used to
measure items of heavier weights. E.g. the weight of garri which are been given
to the patients.
This manual weighing scale is mainly used to actualize the different weighs of
foods that are given to patients usually in regards to their health status or type of
drug intake.

3.2 Measuring Cups and Spoons: These two measuring instruments are
calibrated in milliliters (mls) and liters (l). They are used in measuring liquids

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and semi-liquids such as water, oil, pap and milk mainly during the preparation
of therapeutic fluid diets as well as in food standardization.

3.3 Food Models: Food models are visual aids/arts used by Dietitians to
enlighten their clients during dietary counseling or nutrition education on
complementary foods as well as the required size one should take at a time.

3.4 Electric Blender: A blender sometimes called a liquidizer is equipment

used to mix, puree or emulsify foods and other substances. It is used in the
kitchen section in ensuring proper smoothening of food stuffs (e.g. fresh
tomatoes, onions, eggs, pepper, boiled plantain and yam, vegetables, boiled fish
and meats etc) mainly in fluid diet preparations.
Its importance in the dietetic kitchen can never be over emphasized. This list of
equipment and instruments used in the dietetic department will not be complete
without mentioning it.
When using this appliance one will make sure that the blender is plugged in,
clean, and at a good working condition, the ingredients are properly put inside,
then the lid cover is closed and held tightly before the blender is turned on.
After blending it is opened and poured out, cleaned and stored properly.

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3.5 Stadiometer: This is medical equipment used in ascertaining human height
and weight at a time which are used in determination of a client’s or patient’s
Body Mass Index (BMI). It consists of a ruler, a sliding horizontal head piece
for height measurement and a scale for weight measurement. In the height
measurement, the individual to be measured is made to stand erect on the
stadiometer without any foot wear or heavy wear which may add to the
individual’s original weight, then the horizontal head piece is adjusted to rest on
the top of the head, then the height is read from the calibration of the ruler. And
the individual’s weight measurement is taken at the same time.

3.6 Camping Gas Stove: This is a two burner camping gas stove. It is by far
the most popular type of stove amongst the camping community. Having the
ability to cook in two different pans on one stove allows more flexibility in the
meals that can be cooked.

3.7 Refrigerators: These are used to store vegetables and fruits. These help to
ensure that these items are fresh and ready for use at all times.
3.8 Freezers: These electrical appliances are being used to freeze the meats and
fish that are used in cooking.

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3.9 Cutleries and Other Kitchen Utensils: These are used in cooking of foods
and in the serving of foods.

Some other equipment used at the Dietetics Department includes the

following:
 Diet sheet/daily diet sheet
 Calculator
 Diet register
 Record book
 Charts
 Masking tape and etc.

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 CHAPTER FOUR
EXPERIENCES GAINED AND PROBLEMS ENCOUNTERED
4.1 EXPERIENCE GAINED
In the course of my Industrial Training in Federal Medical Centre (FMC),
Umuahia, Abia State, I acquired the following experiences in the treatment and
managing of foot and toe ulcer;

 Washing the affected area with mild soap.

 Keeping the wound clean and dry.
 Changing the bandages as directed.
 Take prescribed medications as directed.
 Drink plenty of fluids. Ask your healthcare provider how much water you
should drink every day.
 Follow a healthy diet, as recommended by your healthcare provider.
 Exercise regularly, under your healthcare provider’s care.
 Wear appropriate shoes.
 Wear compression wraps as directed.

4.2 DIABETIC FOOT ULCER

4.2.1 Overview

A diabetic foot ulcer is an open sore or wound that occurs in approximately 15

percent of patients with diabetes, and is commonly located on the bottom of the
foot. Of those who develop a foot ulcer, six percent will be hospitalized due to
infection or other ulcer-related complication.

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Diabetes is the leading cause of nontraumatic lower extremity amputations in
the United States, and approximately 14 to 24 percent of patients with diabetes
who develop a foot ulcer have an amputation. Research, however, has shown
that the development of a foot ulcer is preventable. 

4.2.2 Who Can Get a Diabetic Foot Ulcer?

Anyone who has diabetes can develop a foot ulcer. Native Americans, African
Americans, Hispanics and older men are more likely to develop ulcers. People
who use insulin are at a higher risk of developing a foot ulcer, as are patients
with diabetes-related kidney, eye, and heart disease. Being overweight and
using alcohol and tobacco also play a role in the development of foot ulcers.

4.2.3 How Do Diabetic Foot Ulcers Form?

Ulcers form due to a combination of factors, such as lack of feeling in the foot,
poor circulation, foot deformities, irritation (such as friction or pressure), and
trauma, as well as duration of diabetes. Patients who have diabetes for many
years can develop neuropathy, a reduced or complete lack of ability to feel
pain in the feet due to nerve damage caused by elevated blood glucose levels
over time. The nerve damage often can occur without pain and one may not
even be aware of the problem. Your podiatric physician can test feet for
neuropathy with a simple and painless tool called a monofilament.

Vascular disease can complicate a foot ulcer, reducing the body’s ability to heal
and increasing the risk for an infection. Elevations in blood glucose can reduce
the body’s ability to fight off a potential infection and also retard healing. 

4.2.4 Symptoms

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One of the first signs of a foot ulcer is drainage from your foot that might stain
your socks or leak out in your shoe. Unusual swelling, irritation, redness, and
odors from one or both feet are also common early symptoms.

The most visible sign of a serious foot ulcer is black tissue (called eschar)
surrounding the ulcer. This forms because of an absence of healthy blood flow
to the area around the ulcer.

Partial or complete gangrene, which refers to tissue death due to infections, can

appear around the ulcer. In this case, odorous discharge, pain, and numbness
can occur.

Signs of foot ulcers are not always obvious. Sometimes, you won’t even show
symptoms of ulcers until the ulcer has become infected.

4.2.5 Types of Foot and Toe Ulcers

Two types of ulcers can affect your feet and toes:

 Neurotrophic (diabetes-related) ulcers.

 Arterial (ischemic) ulcers.

[Link] Neurotrophic Ulcers

Neurotrophic ulcers occur primarily in people with diabetes, although they can
affect anyone who has impaired sensation in their feet. They can be found
anywhere on your feet, but they usually develop on the parts of your feet and
toes that are most sensitive to weight (pressure points).

Neurotrophic ulcers don’t cause pain. But they can be serious if they aren’t
treated promptly or they don’t respond to treatment.

A neurotrophic ulcer might be the following colors:

 Pink.
 Red.
 Brown.
 Black.
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  Any combination of those colors.

The thin borders of the ulcers are “punched out,” meaning that they’re taller
than the surrounding tissues.

[Link] Arterial Ulcers

A condition called peripheral arterial disease can reduce blood flow to your
extremities. When this happens, your foot tissue may start to die. The ulcers that
form from reduced blood flow are called arterial ulcers.

The word “arterial” means “relating to arteries.” Arteries are blood vessels that
transport blood from your heart to the rest of your body, including your feet and
toes. Anyone can get an arterial ulcer, but people who smoke or have diabetes,
high blood pressure or high cholesterol are at higher risk.

Unlike neurotrophic ulcers, arterial ulcers can form on many parts of your body,
including:

 On your heels.
 On the tips of your toes.
 Between your toes (where your toes rub together).
 The bony parts of your feet and toes that rub against bed sheets, socks or
shoes.
 The nail bed (if your toenail cuts into your skin, if your toenail was
trimmed aggressively or if you had an ingrown toenail removed).

Arterial ulcers are:

 Yellow.
 Brown.
 Grey.
 Black.

Arterial ulcers don’t bleed. The borders and surrounding skin usually appear
taller. If you have an infection or experience irritation, you might see swelling
and redness around the base of the ulcer. The redness often turns to a pale white
or yellow color if you elevate your leg. Arterial ulcers are typically very painful,
especially at night.

4.2.6 Causes of Diabetic Foot Ulcers

Ulcers in people with diabetes are most commonly caused by:

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  poor circulation

 high blood sugar (hyperglycemia)

 nerve damage

 irritated or wounded feet

Poor blood circulation is a form of vascular disease in which blood doesn’t flow
to your feet efficiently. Poor circulation can also make it more difficult for
ulcers to heal.

High glucose levels can slow the healing process of an infected foot ulcer, so
blood sugar management is critical. People with type 2 diabetes and other
ailments often have a harder time fighting off infections from ulcers.

Nerve damage is a long-term effect and can lead to a loss of feeling in your feet.
Damaged nerves can feel tingly and painful. Nerve damage reduces sensitivity
to foot pain and results in painless wounds that can cause ulcers.

Ulcers can be identified by drainage from the affected area and sometimes a
noticeable lump that isn’t always painful.

4.2.7 Risk factors for Diabetic Foot Ulcers

All people with diabetes are at risk for foot ulcers, which can have multiple
causes. Some factors can increase the risk of foot ulcers, including:

 poorly fitted or poor quality shoes

 poor hygiene (not washing regularly or thoroughly or not drying the feet
well after washing)

 improper trimming of toenails

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  alcohol consumption

 eye disease from diabetes

 heart disease

 kidney disease

 obesity

 tobacco use (inhibits blood circulation)

Diabetic foot ulcers are also most common in older men.

 4.2.8 Treatment of Diabetic Foot Ulcers

The primary goal in the treatment of foot ulcers is to obtain healing as soon as
possible. The faster the healing of the wound, the less chance for an infection.

There are several key factors in the appropriate treatment of a diabetic foot
ulcer:

 Prevention of infection
 Taking the pressure off the area, called “off-loading”
 Removing dead skin and tissue, called “debridement”
 Applying medication or dressings to the ulcer
 Managing blood glucose and other health problems

Not all ulcers are infected; however, if your podiatric physician diagnoses an
infection, a treatment program of antibiotics, wound care, and possibly
hospitalization will be necessary.

Preventing Infection

There are several important factors to keep an ulcer from becoming infected:

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 Keep blood glucose levels under tight control
 Keep the ulcer clean and bandaged
 Cleanse the wound daily, using a wound dressing or bandage
 Do not walk barefoot

Off-Loading

For optimum healing, ulcers, especially those on the bottom of the foot, must be
“off-loaded.” Patients may be asked to wear special footgear, or a brace,
specialized castings, or use a wheelchair or crutches. These devices will reduce
the pressure and irritation to the ulcer area and help to speed the healing
process.

The science of wound care has advanced significantly over the past ten years. 
The old thought of “let the air get at it” is now known to be harmful to healing.
We know that wounds and ulcers heal faster, with a lower risk of infection, if
they are kept covered and moist. The use of full-strength betadine, peroxide,
whirlpools and soaking are not recommended, as this could lead to further
complications.

Applying Medication and Dressings

Appropriate wound management includes the use of dressings and topically-

applied medications. These range from normal saline to advanced products,
such as growth factors, ulcer dressings, and skin substitutes that have been
shown to be highly effective in healing foot ulcers.

For a wound to heal there must be adequate circulation to the ulcerated area.
Your podiatrist may order evaluation test such as noninvasive studies and or
consult a vascular surgeon.  

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 Managing Blood Glucose

Tightly controlling blood glucose is of the utmost importance during the

treatment of a diabetic foot ulcer. Working closely with a medical doctor or
endocrinologist to accomplish this will enhance healing and reduce the risk of
complications.

Surgical Options

A majority of noninfected foot ulcers are treated without surgery; however,

when this fails, surgical management may be appropriate. Examples of surgical
care to remove pressure on the affected area include shaving or excision of
bone(s) and the correction of various deformities, such as hammertoes, bunions,
or bony “bumps.”

Healing Factors

Healing time depends on a variety of factors, such as wound size and location,
pressure on the wound from walking or standing, swelling, circulation, blood
glucose levels, wound care, and what is being applied to the wound. Healing
may occur within weeks or require several months.

4.2.9 Value of Treating a Diabetic Foot Ulcer?

Once an ulcer is noticed, seek podiatric medical care immediately. Foot ulcers
in patients with diabetes should be treated for several reasons:

 To reduce the risk of infection and amputation

 To improve function and quality of life
 To reduce health care costs.

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 4.2.10 Prevention of Foot Ulcer

The best way to treat a diabetic foot ulcer is to prevent its development in the
first place. Recommended guidelines include seeing a podiatrist on a regular
basis. He or she can determine if you are at high risk for developing a foot ulcer
and implement strategies for prevention.

You are at high risk if you:

 Have neuropathy
 Have poor circulation
 Have a foot deformity (i.e. bunion, hammer toe)
 Wear inappropriate shoes
 Have uncontrolled blood sugar

Reducing additional risk factors, such as smoking, drinking alcohol, high

cholesterol, and elevated blood glucose are important in the prevention and
treatment of a diabetic foot ulcer. Wearing the appropriate shoes and socks will
go a long way in reducing risks. Your podiatric physician can provide guidance
in selecting the proper shoes.

Learning how to check your feet is crucial in noticing a potential problem as

early as possible. Inspect your feet every day—especially between the toes and
the sole—for cuts, bruises, cracks, blisters, redness, ulcers, and any sign of
abnormality. Each time you visit a health care provider, remove your shoes and
socks so your feet can be examined. Any problems that are discovered should
be reported to your podiatrist or a medical professional as soon as possible, no
matter how “simple” it may seem to you. 

The key to successful wound healing is regular podiatric medical care to ensure
the following “gold standard” of care:

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 Lowering blood sugar
 Appropriate debridement of wounds
 Treating any infection
 Reducing friction and pressure
 Restoring adequate blood flow

4.2.11 Etiology

The etiology for diabetic foot ulcer is multi factorial (controlled by multiple
factors either genetic or environmental factors).

The common underlying causes are poor glycemic control, calluses, foot
deformities, improper foot care, ill-fitting foot wear, underlying peripheral
neuropathy and poor circulation, dry skin etc.

4.2.12 Epidemiology

The annual incidence of diabetic foot ulcer worldwide is between 9.1 to 26.1
million. Around 15 to 25% of patients with diabetes mellitus will develop a
diabetic foot ulcer during their lifetime. As the number of newly diagnosed
diabetes are increasing yearly, the incidence of diabetic foot ulcer is also known
bound to increase. Diabetic foot ulcers can occur at any age but are most
prevalent in patients with diabetes mellitus from age 45 and above.

4.2.13 Pathophysiology

The development of a diabetic ulcer is usually in 3 stages.

 Development of callus.

This usually results from neuropathy.

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The motor neuropathy causes physical deformity of the foot, and sensory
neuropathy causes sensory loss which leads to ongoing trauma.

 Drying of the skin because of autonomic neuropathy.

 Frequent trauma of the callus which results in subcutaneous hemorrhage
and eventually, it erodes and becomes an ulcer.

Patients with diabetes Mellitus also develop severe atherosclerosis of the of

the small blood vessels in the legs and feet, leading to vascular compromise,
which is another cause of diabetic foot infections. This is because blood is not
able to reach the wound, healing is delayed, eventually leading to necrosis and
gangrene.

4.2.14 Classification of D.F.U

 No open lesions.
 Superficial diabetic ulcer [partial or full thickness].
 Ulcer extension to ligament, tendon, joint capsule, or deep fascia without
abscess or osteomyelitis.
 Deep ulcer with abscess, osteomyelitis, or joint sepsis.

4.2.15 Prevention

 Check feet daily

 Touch and inspect the skin of the feet lower legs each day to watch for
any scrapes, bruises, or swelling.
 Don’t walk around barefoot.
 Wear shoes that fit properly etc.

4.2.16 Dietary Management OF D.F.U

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Nutrition is a critical component of wound healing process which is most times
overlooked due to ignorance. It is connected to every facet of healing including
immune function, glycemic control and weight management. In the treatment of
D.F.U it is necessary that:

 Blood glucose level is kept under control: High blood glucose levels
interfere with wound healing and can lead to defective white blood cell
function. Food choices, including the timing and carbohydrate content of
meals and snacks can impact glycemic control. Any form of carbohydrate
when eaten in excess can affect blood glucose levels. So, portion control
of all carbohydrates is important.
 Consuming protein rich foods such as: lean meat, sea foods, egg, milk,
beans, soybean etc to aid wound healing.
 Consuming foods rich in fiber such as whole grains, legumes, vegetables
and fruits.
 Consuming foods rich in minerals and vitamins like: carrot, cucumber,
watermelon, garden egg, cabbage, tomatoes, spinach, oranges etc. to help
boost immune system and also to aid wound healing.

Healing begins from the inside then out. Building new tissues requires calories,
protein and many vitamins (like vit A and C) and minerals.

Poor nutrition can hinder the success of healing diabetic foot wounds.

4.3 CELLULITIS

4.3.1 Overview

Cellulitis is an often painful skin infection. It may first appear as a discolored,

swollen area that feels hot and tender to touch. The discoloration and swelling
can spread quickly.

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 On light skin, cellulitis will typically appear red or pink. On dark skin, it may
appear dark brown, gray or purple. It although the infection can occur anywhere
on a person’s body or force. Cellulitis usually happens on the surface of skin but
it may also affect the tissue underneath the infection can spread to lymph nodes
and blood stream.

4.3.2 Causes

Cellulitis occurs when certain types of bacteria enters the skin through a break
in its surface. Staphylococcus and streptococcus bacteria commonly cause this
infection. The infection can start in skin injuries such as: Cuts, bug bites,
surgical wounds etc.

4.3.3 Symptoms

Cellulitis symptoms include:

 pain and tenderness in the affected area.

 redness or inflammation of your skin.
 A skin sore or rash that grows quickly.
 Tight, glossy, swollen skin.
 A feeling of warmth in the affected area.
 An abscess with pus.
 Fever.
 More serious cellulitis symptom includes:
 shaking, chills, fatigue, warm skin.
 Cellulitis can spread into other parts of the body if left untreated and
symptom that may be experienced are:
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  drowsiness.
 lethargy.
 blisters.
 Red or dark brown streaks on the skin.

4.3.4 Treatment

 Cellulitis treatment typically involves taking antibodies by mouth for a

minimum of 5 days.

In some cases, doctors will administer IV antibodies as soon as they diagnose

symptoms such as;

 High temperature, low blood pressure, an infection that doesn’t improve

with oral antibodies, a weakened immune system due to other diseases.
 Raising the affected limb higher than the heart can help to reduce
swelling.

4.3.5 Complications of Cellulitis

Complications of Cellulitis can be severe if left untreated and they may include:

 Severe tissue damage (Gangrene)

 Amputation

 Damage of internal organs that become infected

 Septic shock

 Death

4.3.6 Diagnosis

Cellulitis can be diagnosed just by looking at the skin. A physical exam might
reveal:

 Swelling of the skin

26
  Redness and warmth of the affected area

 Swollen glands

 In some cases, blood or a sample of the wound may be taken to test for
bacteria.

4.4 Problems Encountered

On the course of my industrial work experience at Federal Medical Centre,
Umuahia, the following problems were encountered;
i. Challenge of combining some academic work during our period of
industrial training e.g Enact (Nutrition Education).
ii. Improper dietary counselling to patients by medical Doctors.
iii. Challenge of getting a place for my Industrial Training programme.
iv. The Nutrition and Dietetics Department of Federal Medical Centre
Umuahia does not have any good or spacious building or office of
their own which could contain the large number of us that were on I.T
in their Department.
v. Challenge of high cost of accommodation, as no accommodation was
provided for SIWES students.
vi. Challenge of high cost of transportation, as no transportation
allowance was provided to for SIWES students.
vii. Challenge of working with an empty stomach (hunger) as no food or
feeding allowance was made available during the working hours.
viii. Dietitians not fully regarded as health practitioners by some patients
as well as some uninformed staff but are regarded as the hospital
cooks.
ix. Disregards to the field of Dietetics by some health practitioners.

27
PART B – FELINA HOTELS AND TOWERS

28
 CHAPTER ONE

1.1 Introduction

A hotel is an establishment that provides paid lodging on a short-term basis.

Facilities provided inside a hotel room may range from a modest-quality
mattress in a small room to large suites with bigger, higher-quality beds, a
dresser, a refrigerator and other kitchen facilities, upholstered chairs, a flat
screen television, and en-suite bathrooms. Small, lower-priced hotels may offer
only the most basic guest services and facilities. Larger, higher-priced hotels
may provide additional guest facilities such as a swimming pool, business
centre (with computers, printers, and other office equipment), childcare,
conference and event facilities, tennis or basketball courts, gymnasium,
restaurants, day spa, and social function services. Hotel rooms are
usually numbered (or named in some smaller hotels and B&Bs) to allow guests
to identify their room. Some boutique, high-end hotels have custom decorated
rooms. Some hotels offer meals as part of a room and board arrangement.

1.2 Name of Institution and Location

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FELINA HOTELS AND TOWERS LIMITED was incorporated in
UMUAHIA, Nigeria with Registration Number 621834. It was registered on 20
Apr 2005 and it's current status is unknown. Company's registered office
address is 52 ABA ROAD, UMUAHIA, ABIA.

This hotel, located along the ever busy Aba road is an oasis of modern facilities,
savvy services and relaxation in the heart of Umuahia. The hotel's lush, peaceful
and beautiful ambience offers a haven like no other. Its central location gives
guests easy access to the major business and entertainment centres in Umuahia.

A unique hotel experience, from the designer bedrooms, sumptuous fine dining
restaurant, to the industrial-chic destination bar. Rooms are luxuriously
furnished and tastefully decorated. Whichever of our rooms you decide to
choose for your stay, you will be assured of the ultimate comfort, tranquillity,
convenience and service - just as you would expect from a top international
hotel. Some of our room facilities include a cosy bed, sofas, a desk, air
conditioning and cable TV with multiple channels for your entertainment. At
the restaurant, we offer a selection of light meals, snacks, local dishes and
continental dishes in a modern environment. You can come relax here during
leisure with friends and family. Added advantages of lodging here are the ample
parking space, privacy, security and power supply. Room rates are fair for what
you'll get. Felina Hotels is an affordable hotel in Umuahia , Abia.

1.3 Mission, Vision Statement and Strategy

1.3.1 Mission

The mission of the Hotel Grand is to put hospitality services on the highest level
in order to satisfy the demands and expectations of guests. Our aim is to make
the Hotel Grand a place for encounters, business success, pleasant meetings and
gala ceremonies.

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1.3.2 Vision
The ideology of our vision is to continue to apply and set the highest standards
of service quality and in that way justify and uphold the reputation that we have
among the guests, partners, competitors and the wider community. We use and
constantly introduce environmentally friendly technologies and processes in
order to remain in balance with nature and also meet the needs of contemporary
society. Tradition is a testament to our success but in the future we also want to
embrace the changes that modern time brings and become more attractive in the
market and more interesting to our guests and partners.

1.3.3 Strategy
Our strategy is based on:

i. Partnership with guests

Guest satisfaction is the most important thing for us and we try with our
quality of services to exceed their expectations. Our goal is to make every
guest feel like at home and that for this reason he chooses Hotel Grand
again for his accommodation facility. We provide services at the highest
level that will meet the needs and expectations of guests and will
recognize their requirements through open communication, satisfaction
monitoring and analysis of compliments and complaints.

ii. Employees
Accepting new knowledge and technologies is a condition for progress
including quality training and education.
Because of that our strategy is based on the education and training of all
employees and constant communication between all departments of the
hotel. We support teamwork, personal responsibility and initiative of each
employee.

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 iii. Relations with suppliers
Purchase as one of the most important departments in the hotel requires a
choice of reliable suppliers that allows us to provide the guest, who is the
end-user of services, with highest quality and more adequate
accommodation in the Hotel Grand. We will base our relationship with
suppliers on mutual interests and on the development of good
partnerships.
iv. Satisfaction of interesting parties
Hotel Grand will improve the volume and structure of hospitality
services, thereby satisfying the wishes and expectations of all parties:
guests, business partners, travel agencies, NGO, government and sports
institutions, employees, owners and suppliers.
The guest who returns, the employee who progresses, the capital that is
growing!

1.4 Organogram of Felina Hotels and Towers

MANAGER

ASSISTANT
MANAGER
HEAD OF
SUPERVISOR
KITCHEN STORE
SUPERVISOR I SUPERVISOR II
BAR MANAGER

RECEPTIONIST ACCOUNT MANAGER

HEAD
CHEF
KITCHEN KITCHEN
ASSISTANT I ASSISTANT II

PORTER 32HOUSE KEEPING LAUNDRY

WAITER/WAITRESS SECURITY
 CHAPTER TWO

DIFFERENT SECTIONS / DEPARTMENTS IN A HOTEL

2.1 Management and Finance Department

A hotel manager needs to function well under pressure and must be ready to
perform tasks that require a range of skills. A hotel manager must be able to go
from conducting staff interviews or coping with plumbing or electrical issues, to
handling complaints from guests and more. As well as taking care of essential
services like guest rooms and catering, a manager will need to interact with
suppliers and outside contractors, supervise conferences and other events,
oversee maintenance, upkeep and renovations, and troubleshoot any problems
that crop up.

Hotel managers are also responsible for conducting inspections and generally
ensuring safety, security and compliance with regulations. It’s important for
hotel managers to keep occupancy levels as high as possible, as well as deal
with many of the financial aspects of the business. They need to track revenue

33
and expenditure, manage budgets, optimise profits, analyse sales and set targets,
and identify optimal pricing and distribution

2.2 Front Office Hotel Department

The front office is often termed the “face” of the hotel. The Front Office
handles checking in and out, assignment of rooms and rates, room status
tracking, payments, and guest records. This department also develops and
maintains an accurate and up-to-date record of guest information, manages
guest services, and generally works to ensure customer satisfaction.

The activities of the Front Office are very important for the hotel’s relationship
with the public, as it’s the first point of contact for guests and other visitors. A
front office department that runs smoothly and efficiently will make all the
difference to guest satisfaction. As well as handling reservations and payments,
the front office will also be fielding requests, queries and complaints, liaising
with other departments to ensure that guests’ needs are met.

2.3 Food & Beverage Hotel Department

Food and Beverage (often shortened to F&B) is one of the most important
departments in any hotel. Both casual visitors and hotel guests need to be
provided with food and drink. It’s often the biggest department in the hotel and
is tasked with procuring food, drinks and materials, as well as storage,
preparation and serving. The serving of food and beverages might take place in
the setting of a restaurant or bar, as part of room service, or in the context of
conferences and similar events.

If the hotel has a restaurant on the premises, F&B will typically be one of the
largest departments in terms of both operation and revenue, second only to the
rooms department. Bars and restaurants will also help shape public perceptions

34
of the hotel, as casual visitors will often be dropping by to eat or drink even if
they don’t stay at the hotel. The F&B department thus has a significant impact
on hotel revenue.

2.4 Housekeeping Hotel Department

The housekeeping department is responsible for ensuring that the rooms and
other spaces in and around the hotel are clean, inviting, well-maintained and
safe. It’s the job of the housekeeping department to see that the entire hotel —
the guest rooms and suites, the public areas, the staff areas, and exterior spaces
like the grounds and parking facilities — are aesthetically appealing and that
everything is in good condition.

Housekeeping will primarily coordinate with the front office department, as

they are responsible for turnarounds (cleaning and making up rooms in between
guests), as well as handling some guest services like providing extra towels, bed
linen, or toiletries. Housekeeping will also be liaising with the maintenance or
engineering department when repairs need to be made. Of course, they will have
regular interactions and meetings with hotel management in order to ensure that
everything runs smoothly.

2.5 Maintenance Hotel Department

The maintenance department is responsible for the physical upkeep of all the
hotel buildings. This department is tasked with overseeing the repair and
operation of the plumbing, heating, air conditioning and ventilation systems.
Maintenance is also responsible for overseeing any cold water plants or central
steam systems. The maintenance department will typically have a regular
schedule to follow but may also handle requests when they come in. It’s their
job to make sure that all of the equipment and facilities in the hotel are kept in
good order.
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Proper maintenance is important, as breakdowns in any system can affect the
smooth running of the hotel. There are two kinds of maintenance. Protective
maintenance is the general inspection and upkeep of systems to prevent
breakdowns or malfunctions. Reactive maintenance includes repairs and
replacements for systems or equipment once a problem has arisen. The
maintenance department will handle both.

2.6 Reservations & Marketing Hotel Department

The reservations department’s responsibilities include making and adjusting

hotel bookings. They are also tasked with making sure that room availability is
updated and kept current, avoiding errors such as over or underbooking. This
department will liaise directly with travel agents and tour operators. They’ll also
work closely with marketing in order to optimise room sales. Reservations and
marketing will thus bear much of the responsibility for building hotel revenue.

Programmes must be developed in order to make the most profitable use of the
hotel’s rooms and other facilities, increasing occupancy through effective
marketing and promotion, and determining optimal price points. It’s the task of
reservations and marketing departments to make sure that the hotel’s revenue is
everything it can be. This means that their activities can have a dramatic effect
on the successful operation of the hotel.

2.7 Human Resource Hotel Department

Well-trained, experienced staff are crucial to the successful operation of a hotel.

It’s the responsibility of the human resources department to recruit staff, deploy
them in appropriate roles, train them and make sure their skills remain up to
date. The human resources department is tasked with developing the hotel’s
personnel. Part of the HR department’s job is also the assessment of
performance and compliance with hotel regulations. This means that HR will
36
also be engaged in administering an internal justice system, ensuring that this is
impartial and transparent.

The role of a modern HR department isn’t simply the hiring and firing of staff.
It is to manage and develop the hotel’s human resources, assisting employees in
their professional development and skills acquisition so that they can fulfil their
roles most effectively. Because staff will have regular contact with the public
and because the quality of their work directly affects the guest experience, an
effective HR department is essential.

CHAPTER THREE
EQUIPMENT AND INSTRUMENTS USED AND USES
3.1 Gas Cooker
This is a stove that uses gas as its fuel source. It is used for cooking, grilling and
baking.

3.2 Electric stove

This stove converts electrical energy into heat to cook and bake.

3.3 Freezers

37
Freezers are used for preserving cooked foods and perishable raw foods used
meanly for cooking in the kitchen. Stocks and stuffs which are used for
preparation of foods are collected when needed.

3.4 Refrigerators
They are used for preservation. They are used to preserve perishable fruits,
vegetables, beverages, water and drinks.
Beverages, water and drinks are preserved and chilled in deferent refrigerators
to avoid change in taste.

3.5 Micro Wave Oven

This is used for instant heating of already prepared food. The food to be heated
is placed inside the oven and the control buttons are used to set how long the
food should be cooked.

3.6 Electric Iron

This is an important electrical appliance used at the laundry section for ironing
of cloth items and guests wears.

3.7 Mops and Mops Carts/Wringer Trolley

Mops are hairy head long stick materials used by the housekeepers for cleaning
of the floors.

3.8 Intercom Telephone

This is an important communication call system that has connection to all the
rooms. The guests have this call system in their rooms and can be used to make

38
requests and orders for either foods or drinks from their rooms as the case may
be. This call system can be used to contact any guest when needed.

3.9 Cutleries
Cutleries are used for eating. When serving food they are been rapped with a
servlet in an attractive way.

3.10 Kitchen Utensils

These are used for the preparation of meals and other kitchen activities.

CHAPTER FOUR
EXPERIENCES GAINED AND THEN PROBLEMS ENCOUNTERED
AT FELINA HOTELS AND TOWERS, UMUAHIA.

4.1 Experiences Gained

My Industrial training experience at Felina Hotels and Towers was a beneficial

one because I gained so many experiences, the experiences and skills acquired
are listed below:

a. Teamwork: No matter what job you might be planning to get, it’s more
likely than not that you’ll end up working with other people. The ability
to read them, interact and build relationships is priceless.
Whether working in a restaurant, a hotel or for a staffing agency on
various exciting shifts, you have to learn how to handle different people
and act as a team and a united front; regardless of whether you have a
personal preference.

39
 Teamwork is a key skill and working in hospitality helps you grasp and
master it to the fullest extent.
b. Flexibility: Some shifts may run longer than planned, some may finish
early. Hospitality workers know that in order to survive they have to
adapt and be flexible to accommodate changes which may not always be
in the management’s power.
You might not read much into your manager calling you last minute and
you showing up for a shift when someone else couldn’t; but, flexibility
and willingness to help are hugely appreciated by any employer.
Managing an employee who’s willing to adjust to the situation at hand is
a breeze; and those moments when you’re flexible do not get unnoticed,
regardless of whether you’re working in hospitality or another industry.
c. Customer service: This skill is so underrated when going into some
other industries; and yet so valuable. Working in hospitality teaches you
patience and politeness.
When dealing with guests you often have to balance the ‘client is always
right’ attitude with the applicable policies of the place you’re working in.
So, diplomacy becomes your best friend.
At the same time, you learn to subtly sell yourself and the services of the
brand you work for; all part of customer service and useful across a range
of situations!
d. Crisis management: In such a fast-paced environment, crisis is
something that you cannot avoid. The knowledge of how to deal with it
is, however, a fantastic skill.

Working in hospitality instantly teaches you to think quick on your feet

and solve the situations that present themselves promptly, creatively and
to the point.
e. Multitasking: Taking orders, running plates, answering random
questions; all while fully functioning socially while focusing on a
particular task at hand is an undeniable skill. And- don’t let anyone tell
you otherwise.

40
 While some shifts can be quite calm, others may make you want to rip
your hair out; while carrying a tray full of drinks and taking orders, of
course.
When working in hospitality, you develop a great ability to divide your
attention, prioritise and just get things done. The better you get at
multitasking, the calmer you approach stressful situations. An added
benefit? When you’re busy multitasking, time simply flies by.
f. Endurance: If you’ve ever worked a 10 hour waiting shift you will know
what we mean. While fun and often very sociable, hospitality can be
absolutely exhausting. Being on your feet and physically challenging
yourself while working definitely teaches you endurance.
It also strengthens your immunity against things that are simply not worth
the hassle. And, it rewards you with that amazing feeling of
accomplishment when you’ve survived yet another hard day.
g. Attention to detail: Setting a table for an event is an art; just like
painting a masterpiece, every tiny detail matters. There are a lot of jobs,
whether in an office environment or not, that will require attention to
detail.
Working in hospitality teaches you that when the competition for
perfection is so vast, it’s the little details that take you over the finish line
to win over your clients. Remember, the devil is in the detail.
h. Time management: This one’s so crucial. When so many people depend
on your work, every second counts. Because of this, lateness is just not
acceptable for most hospitality employers. And, this skill might be the
one that comes in handy the most when you change jobs.
While not all industries require you to always be on time, especially with
so many flexible working environments nowadays, lateness is certainly a
major pet peeve for many people. Plus, you don’t accidentally want to get
on your new boss’ bad side by such a trivial thing as being late.
i. Respect: Working in hospitality teaches you RESPECT. Respect for all
those people who devote their time to make your day easier or your
experience more extravagant and special.
A person who has worked in hospitality has a different understanding of
patience and hard work. You will be less likely to lash out on a

41
 receptionist or a waitress, knowing there is nothing they can do about the
situation at hand. Especially if you’ve ever found yourself on the
receiving end of such a treatment.

4.2 Problems Encountered

a. Lack of patience by some establishments to accommodate people that are yet
to be trained to be able to fit in to their industrial world.
b. High cost of transportation to work.
c. I was not allowed to participate fully in all the sections of the establishment.
d. Challenge of poor establishments or food industries with relevant equipment
and facilities to train Industrial Training students.
e. Rejection of Industrial Training students by some establishments.
f. Some hotel owners and managers requesting to sleep with students before
giving them an attachment space for Industrial training.

4.3 Solutions to the Problems Encountered

 Government should assist individual organizations in procuring needed
facilities that will give enabling environment and help the students gain
required experience during this period of industrial attachment.
 Stipends should be made available to students to help them cope with
daily expenses during the course of this industrial training.
 The few available industries should be encouraged to accept students for
Industrial Training programme.
 More industries/establishments with sufficient facilities should be created
so as to accommodate the large number of students that come to
industries for their Student Industrial Work Experience programme.

42
  Industrial based supervisors should be encouraged to allow the students
participate if not in all the sections but fully in the sections that would be
of more importance to their fields of study.
 The institution should have relationship with some standard hotels in
order to refer or post students to those hotels.

CHAPTER FIVE

SUMMARY, CONCLUSION AND RECOMMENDATION

4.1 Summary

The industrial training which I undergo at Federal Medical Centre (FMC),

Umuahia and Felina Hotels and Towers exposed me immensely to the real
world of food nutrition and clinical services.

During my stay, I was exposed to various forms of working experiences, such

as; food testing, quality control, food analysis, food packaging and

43
management, health management, different test carried out on a sick person and
above all, how to record a test report.

4.2 Conclusion

The student industrial Work Experience Scheme is a great scheme its

importance cannot be overstated. It enables students to tackle practical problems
that are outside the school confines, and exposes them to the real life
environment, so that they can adjust to the real world they are going to meet
when they leave school.

4.3 Recommendations

I recommend that this internship program should be made compulsory to all

Nigeria students and a medium should be made to ensure it. The industrial
training is very pertinent that the government on their own part needs to show
more concern to the students enrolled for this program, so that engineering and
other science inclined disciplines will be adequately trained not only theory but
also expose them to practical or field works.

44